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      Radiofrequency ablation of accessory pathways in patients with the Wolff-Parkinson-White syndrome: the long-term mortality and risk of atrial fibrillation

      , , , , , , ,

      Europace

      Oxford University Press (OUP)

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          Abstract

          To assess the long-term mortality and occurrence of post-ablation atrial fibrillation in patients undergoing a radiofrequency ablation for the Wolff-Parkinson-White (WPW) syndrome.

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          Most cited references 20

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          Validity of the diagnoses atrial fibrillation and atrial flutter in a Danish patient registry.

          To assess the validity of the diagnoses of atrial fibrillation (AF) and atrial flutter (AFL) for men and women recorded in the Danish National Patient Registry, and to assess the relative distribution of AF and AFL. Review of medical records for incident cases of AF and/or AFL in the Diet, Cancer, and Health cohort study. Participants were enrolled in 1993-97 with 13.6 years of follow-up until 30 December, 2009. The positive predictive value of the combined diagnosis of AF and/or AFL was 92.6% (95% CI 88.8%; 95.2%) with no significant difference between sexes (men 93.7% (133/142), women 90.8% (129/142)). The proportion of AFL either alone or in combination with AF was significantly higher in men than in women (13.5% (18/133) vs. 5.4% (7/129), p =0.03). The positive predictive value of the specified diagnosis of AFL was 57.5% for men (46/80) and 29.6% for women (8/27). This study shows that the validity of the diagnosis of AF and/or AFL is high and may be used for registry-based studies. A specified diagnosis of AFL was rarely used and was not reliable to distinguish between cases of AF and AFL.
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            Aborted sudden death in the Wolff-Parkinson-White syndrome.

            In a population of 690 patients with Wolff-Parkinson-White (WPW) syndrome referred to our hospital from January 1979 to February 1995, 15 patients (2.2%) had an aborted sudden death out of the hospital. This retrospective study examines their clinical and electrophysiologic characteristics. Gender, accessory pathway localization, and presence of multiple accessory pathways were compared between patients with and without spontaneous ventricular fibrillation (VF). Whereas gender and the presence of multiple accessory pathways did not significantly differ between both groups, septally located pathways occurred significantly more often in the VF group. In patients with aborted sudden death, spontaneous VF was found significantly more often in men (13 of 15). VF was the first manifestation of the WPW syndrome in 8 patients. The remaining 7 patients had documented episodes of atrial fibrillation, circus movement tachycardia, or both (n = 2). Ten of the 15 patients were exercising or under emotional stress at the time of aborted sudden death. Only 1 patient had 2 accessory pathways. The location of the accessory pathway was septal (midseptal or posteroseptal) in 11 patients, left lateral in 4, and right lateral in 1).
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              Impact of clinical history and electrophysiologic characterization of accessory pathways on management strategies to reduce sudden death among children with Wolff-Parkinson-White syndrome.

              This study sought to determine whether the clinical and electrophysiologic criteria developed in adults also identify children with Wolff-Parkinson-White syndrome at risk for sudden death. In adults with Wolff-Parkinson-White syndrome, a shortest RR interval <220 ms during atrial fibrillation is a sensitive marker for sudden death. However, because reliance on the shortest RR interval has a low positive predictive value, the clinical history has assumed a pivotal role in assessing risk. This approach has not been evaluated in children. We retrospectively evaluated 60 children
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                Author and article information

                Journal
                Europace
                Europace
                Oxford University Press (OUP)
                1099-5129
                1532-2092
                December 31 2014
                January 01 2015
                July 10 2014
                January 01 2015
                : 17
                : 1
                : 117-122
                Article
                10.1093/europace/euu176
                25013013
                015761f9-bc91-4905-bb86-cc4aac4481ba
                © 2015

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